Echocardiogram context measurement tool

ABSTRACT

A system (100) includes an echocardiogram measurement tool (150) that determines a subset (152) of measurements from a list of echocardiogram measurements according to a view of an ultrasound imaging sequence (110) and a mapping (154) between the view and the subset of measurements.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is the U.S. National Phase application under 35 U.S.C.§ 371 of International Application No. PCT/EP2018/054854 filed Feb. 28,2018, published as WO 2018/158277 on Sep. 7, 2018, which claims thebenefit of U.S. Provisional Patent Application No. 62/465,177 filed Mar.1, 2017. These applications are hereby incorporated by reference herein.

FIELD OF THE INVENTION

The following generally relates to ultrasound echocardiograms, and morespecifically to echocardiogram measurements.

BACKGROUND OF THE INVENTION

Echocardiograms are performed to monitor and diagnosis heart diseaseand/or heart condition. A system that performs echocardiograms typicallyuses ultrasound (US) waves to create imaging sequences of a functioningheart with a probe that generates the ultrasound waves and detectsreflected ultrasound waves.

US imaging sequences can include two dimensional (2-D) images,three-dimensional (3-D) images, Doppler imaging techniques, combinationsand the like. An echocardiogram can include a multitude of sequences.Each sequence is typically an image of a portion of the heart over acycle or at a phase.

The orientation of the probe relative to the heart determines thecontent of the image or view. The orientation of the probe relative tothe heart includes a position and an angle of the probe on the skin of apatient, and thus, a direction of the waves relative to the heart andthe portion of the heart included in the view. Views can includesub-views, which are minor adjustments in position and/or angle of theprobe that focus on particular anatomical portions of the heart.

Measurements are made using the imaging sequence to quantify an aspectof an anatomical portion of the heart. The measurements are quantified,such as functions of a length, a width, a diameter, an area, a volume,combinations and the like. The measurements can be made at a specificphase of a cardiac cycle represented in the sequence. The anatomicalportion measured can include aspects of an atrium, a ventricle, avessel, a valve, and the like.

In quantifying aspects of the echocardiogram, a healthcare practitionerselects a measurement from a list of measurements that pertain toechocardiograms. The list of measurements, typically orderedalphabetically, can include over two hundred different measurements. Thelist can be very large even using abbreviations, such as LV for leftventricle, MV for mitral value, and the like. For example, in a displayscreen of an echocardiogram system, the abbreviated list can fill halfthe screen, temporarily obscuring half of the information concerning theechocardiogram.

SUMMARY OF THE INVENTION

Aspects described herein address the above-referenced problems andothers.

The following describes embodiments of a system and method for acontextual based list of echocardiogram measurements. The context isdetermined from a view or sub-view of an echocardiogram imaging sequenceand a mapping between the view or sub-view, anatomy displayed within theview or sub-view, and an echocardiogram measurement corresponding to thedisplayed anatomy. In some embodiments, the mapping includes furthercontext according to usability statistics. In some embodiments,autonomous measurements are applied according to the context. In someembodiments, the view or sub-view is determined from analysis of theechocardiogram imaging sequence.

In one aspect, a system includes an echocardiogram measurement tool thatdetermines a subset of measurements from a list of echocardiogrammeasurements according to a view of an ultrasound imaging sequence and amapping between the view and the subset of measurements.

In another aspect, a method includes determining a subset ofmeasurements from a list of echocardiogram measurements according to aview of an ultrasound imaging sequence and a mapping between the viewand the subset of measurements.

In another aspect, a non-transitory computer-readable storage mediumcarrying instructions controls one or more processors to determine asubset of measurements from a list of echocardiogram measurementsaccording to a view of an ultrasound imaging sequence and a mappingbetween the view and the subset of measurements

These and other aspects of the invention will be apparent from andelucidated with reference to the embodiment(s) described hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention may take form in various components and arrangements ofcomponents, and in various steps and arrangements of steps. The drawingsare only for purposes of illustrating the preferred embodiments and arenot to be construed as limiting the invention.

FIG. 1 schematically illustrates an embodiment of a system for contextselected measurements of echocardiogram sequences.

FIG. 2 illustrates an example of a displayed echocardiogram sequencewith a context based view of measurements.

FIG. 3 flowcharts an embodiment of a method of context based view ofechocardiogram measurements.

DETAILED DESCRIPTION OF EMBODIMENTS

With reference to FIG. 1, an embodiment of a system 100 for contextselected measurement of an echocardiogram ultrasound sequence 110 isillustrated. An ultrasound (US) imaging scanner 120 scans a subjectusing a probe 122 and generates the sequence 110. The sequence 110 is anultrasound image generated from a view determined by the operation ofthe probe 122 relative to the heart of the subject. The view determinesanatomical portions of the heart present in the sequence 110.

The view can be represented as a single data element or include asub-view and be represented as a combined data element. The sub-view canbe nested at different levels N>1. For example, a first sub-view 1 ofview PLAX includes sub-views A and B, which identify the views of PLAX,PLAX1, PLAX1A, and PLAX1B. PLAX1, as an intermediate nested, level, canbe omitted. Views can be represented by textual explanations, numericalreferences, or combinations thereof. For example views can representedby textual explanations or abbreviations, such as Parasternal long axis(PLAX), Parasternal short axis (PSAX), Apical four chamber (AP4), Apicalfive chamber (AP5), Apical two chamber (AP2), Apical three chamber(AP3), Sub costal (SC), and Supra sternal notch (SSN). In anotherexample, PLAX3 represents a combination of textual and numericalrepresentation that includes a sub-view.

A sequence tagging unit 130 determines the view from an analysis of thesequence 110. The analysis can include pattern matching of the pixeldata with reference images. The analysis can include segmentation ofanatomical features and comparison with an anatomical model. In someembodiments, tagging can include, via a console or computing device 140,an entry of a view, a selection of a view, a display of the view and amodification of the view, combinations thereof and the like.

The computing device 140 or console can be part of, combined with, orseparated from the US imaging scanner 120. The computing device 140includes one or more processors 142, such as a digital processor, amicroprocessor, an electronic processor, an optical processor, amulti-processor, a distribution of processors including peer-to-peer orcooperatively operating processors, client-server arrangement ofprocessors, and the like. The arrangement can include a network 144,which can include a bus structure or other internal or localcommunication structure, wireless or wired communications, public orprivate network communications, cellular or data communications,combinations thereof and the like. The computing device 140 can beconfigured as a laptop computer, a desktop computer, a tablet, asmartphone, a body worn device, and the like.

An echocardiogram measurement tool 150 determines a subset 152 ofmeasurements from a list of echocardiogram measurements according to theview of the sequence 110 and a mapping 154 between the view and thesubset 152 of measurements. For example in a PLAX3 view, measurements,such as left ventricular ejection fraction (LVEF), are included in thesubset 152, while measurements, such as a diameter of the inferior venacava (IVC Diam), are excluded from the subset 152. That is, the PLAX3view is mapped to LVEF and is not mapped to IVC Diam. The PLAX3 viewincludes the anatomical portions of the left ventricle sufficient tocompute the LVEF. The PLAX3 excludes the anatomical portions of theinferior vena cava sufficient to compute the IVC Diam and thus, the IVCDiam is not mapped according to the PLAX3 view. The mappings aredetermined according to the anatomy present in a view, and the anatomywith which the measurements are performed.

The mapping of echocardiogram measurements 154 can be represented andstored as a lookup table with data elements of a view and a measurement.For example, a table can include rows, each row representing ameasurement according to a view. A view can include multiplemeasurements. Data elements or columns include the view and thecorresponding measurement. The table can include other elements of themapping, such as the anatomical portion according to the view to whichthe measurement applies, a link to the specific measurement forprogrammatic access, and the like.

A user interface 160 displays the sequence 110 and the determined subset152 of measurements in a selectable list, such as in a menu, in adrop-down box, in a pick list, and the like on a display device 162. Insome embodiments, the subset 152 is displayed at the top of the entirelist of echocardiogram measurements showing the subset 152 on top of allpossible measurements. In some embodiments, the remainder ofmeasurements in the entire list of echocardiogram measurements(excluding the subset 152) are shown in a sub-menu or expansion box.That is, the entire list can be accessed through a sub-menu or expansionbox. The sub-menu or expansion box does not display the remainder of themeasurements until invoked, which, in some instances, does not obscureportions of the display. In some embodiments, individual measurements inthe subset 152 are shown as active and those not included in the subset152 are shown inactive, such as grayed out and non-selectable. In someinstances, the displayed subset of measurements significantly shortensthe number of displayed measurements, which covers less of the display162 and reduces the number of measurements a healthcare practitionersearches to select a measurement. The display device 162 is suitablyembodied by a computer display, smartphone display, projector, body worndisplay, and the like.

An input device 132, such as a keyboard, mouse, microphone, and thelike, sends an input indicative of a selected measurement, such as aninput indicative of a measurement in the displayed subset 152. Themeasurement tool 150, in response to the input, measures an aspect ofthe heart in the view according to the selected measurement. Forexample, in response to a mouse click selecting a left ventricleejection fraction, the measurement tool measures the left ventricleejection fraction according to the sequence 110.

In some embodiments, the measurement tool 150 autonomously selects andapplies a measurement from the subset 152 of measurements to the taggedview prior to display by the user interface 160. The measurement fromthe subset 152 can be autonomously selected according to site policiesor usability statistics, such as frequency of use by a healthcarepractitioner, frequency of use by a group of practitioners, percentageof echocardiogram usage, percentage of sequence usage, threshold numberof uses, and the like. For example, prior to display of the sequence110, a measurement applied with a high frequency can be selected andapplied by the measurement tool 150. The measured value can be includedin the initial display of the sequence 110 or added to the displaywithout the input for selecting the measurement from the list. In someembodiments, the autonomously selected and applied measurements areindicated with an icon or other symbol in the displayed subset.

The computer device 140 includes the processor 142 and a memory 164. Themapping 154 is suitably embodied by a configured electronic storagemedium, such as local disk, cloud storage, server storage, remotestorage and the like, accessed by the configured processor 142. Theconfigured electronic storage medium can include system file structures,relational and/or object oriented database system structures, datastructures, and the like.

The sequence tagging unit 130, the measurement tool 150 and the userinterface 160 are suitably embodied by the processor 142, configured toreceive the sequence 110, determine the view, generate the subset 152,display the sequence 110 and the subset 152, receive a selection andperform the measurement according to the selection.

The configured processor 142 executes at least one computer readableinstruction stored in the computer readable storage medium 164, such asan optical disk, a magnetic disk, semiconductor memory of a computingdevice with the configured processor, which excludes transitory mediumand includes physical memory and/or other non-transitory medium toperform the disclosed techniques. The configured processor may alsoexecute one or more computer readable instructions carried by a carrierwave, a signal or other transitory medium. The lines between componentsrepresented in the diagram represent communications paths.

With reference to FIG. 2, an example of a displayed echocardiogramsequence 110 with a context based view of measurements that is a subset152 of the list of echocardiogram measurements is illustrated. Thecontext is based on the determined view of the sequence 110, such asPLAX. The determined view can include subviews. That is, the determinedview can be specified at different levels of granularity. For example, aview can be PLAX, PLAX1, or PLAX1A, where PLAX1 is a subview of PLAX,and PLAX1A is a subview of PLAX1. PLAX1 further refines or delineatesPLAX and PLAX1A further refines or delineates PLAX1. Each refinement ordelineation can correspondingly refine or delineate anatomy present inthe view.

Values of data elements, such as of the view 200, the anatomy 210, theusability statistics 230 or combinations thereof can be included in thedisplayed subset 152. In some embodiments, the values of the view 200,the anatomy 210 and the usability statistics 230 are omitted from thedisplay. The values of the measurement data element 220 orrepresentations thereof are included in the display, such as LVEF, IVCDiam, and the like. Representations of the measurement data element 220can include abbreviations, icons, or other indicators.

The values or instances of the measurement data element 220 for thesubset 152 are displayed in the selectable list. The data elementsillustrate the relationship between values of the view/subview 200 thatare mapped to values of the anatomy 210, and values of the anatomy 210are mapped to measurements included in the subset 152. The values of theanatomy are portions of the heart anatomy, such as left ventricle, leftatrium, aorta, mitral value, aortic valve, sub anatomical portions oreach, combinations of each, and the like. In some embodiments, the heartanatomy can include a phase, such as left ventricle end-diastolic.

In some embodiments, the subset 152 is ordered according to usabilitystatistics 230 or combinations of usability statistics 230 and anatomy210. For example, a measurement within a highest frequency of use isdisplayed first. In another example, measurements are ordered withinanatomy 210. For example, measurements mapped from the anatomy of theleft ventricle are ordered by frequency and grouped together, andmeasurements of the right ventricle are ordered by frequency and groupedtogether. In some instances, the context is based on the view and insome instances the context is based on combinations of the view andusability statistics.

With reference to FIG. 3, an embodiment of a method of context basedview of echocardiogram measurements is flowcharted.

At 300, an echocardiogram sequence 110 is received. The echocardiogramsequence 110 can be received directly from the US imaging scanner 120 orfrom computer memory or storage.

At 310, a view of the sequence 110 is determined. The determined viewcan include sub-views. In some embodiments, the view is determined byanalysis of the ultrasound image data. The analysis can include patternmatching of the pixel data with reference images. The analysis caninclude segmentation of anatomical features and comparison with ananatomical model. In some embodiments, the view is determined by manualreview and/or input.

At 320, a subset 152 of measurements is determined from the list ofechocardiogram measurements according to the view and a mapping 154between the view and the subset 152. The mapping 154 includes a firstsub-mapping from the view to portions of heart anatomy within the view,and a second sub-mapping from portions of heart anatomy within the viewto the subset 152 of measurements. A lookup table can store the mappingsbetween the views and the measurements. The lookup table includes dataelements of the view and the mapped measurement. The lookup table caninclude usability statistics 230. The usabilities statistics can beaccording to system, organization, site, user or combinations thereof.For example, in a PLAX view, use can be tracked, such as a total numberor a percentage frequency of the LVEF being measured in the PLAX view, atotal number or a percentage frequency of the LVEF being measured by acurrent user in the PLAX view, and the like.

At 330 the determined subset 152 of measurements in a selectable listand the view of the ultrasound imaging sequence are displayed on thedisplay device 162. The displayed subset 152 can be ordered according tothe usability statistics. For example, the determined subset 152 ofmeasurements can be ordered to a total number or a percentage frequencyof use in the displayed subset 152

At 340, in response to an input from the input device 132, an aspect ofthe heart in the view is measured according to a selected measurement inthe displayed subset of measurements. For example, a user selects theLVEF with a mouse click, the LVEF is measured according to the receivedsequence 110.

In some embodiments, steps 330 and 340 are omitted, and at least onemeasurement of the subset of measurements is selected and applied to theview of the ultrasound imaging sequence autonomously. For example, ameasurement is designated as autonomous within a view, such as LVEFwithin PLAX according to a site policy or the useability statistics.Autonomous measurements can be indicated in the lookup table, such aswith a separate data element with a binary value. The autonomousmeasurement is applied to the received sequence 110 prior to displayingthe received sequence 110, such as upon being received.

The above may be implemented by way of computer readable instructions,encoded or embedded on a computer readable storage medium, which, whenexecuted by a computer processor(s), cause the processor(s) to carry outthe described acts. Additionally or alternatively, at least one of thecomputer readable instructions is carried by a signal, carrier wave orother transitory medium.

The invention has been described with reference to the preferredembodiments. Modifications and alterations may occur to others uponreading and understanding the preceding detailed description. It isintended that the invention is constructed as including all suchmodifications and alterations insofar as they come within the scope ofthe appended claims or the equivalents thereof. The word “comprising”does not exclude other elements or steps, and the indefinite article “a”or “an” does not exclude a plurality.

The invention claimed is:
 1. A system, comprising: an echocardiogrammeasurement tool configured to determine a subset of measurements from alist of echocardiogram measurements based on a view of an ultrasoundimaging sequence and a mapping between the view and the subset ofmeasurements, wherein the subset of measurements are applicable toanatomy in the view, and measurements of the list of echocardiogrammeasurements not in the subset of measurements are not applicable to theanatomy in the view; and a user interface configured to display thedetermined subset of measurements in a selectable list and the view ofthe ultrasound imaging sequence on a display device; wherein theechocardiogram measurement tool, in response to an input, measures anaspect of the heart in the view according to a selected measurement inthe displayed subset of measurements indicated by the input.
 2. Thesystem according to claim 1, wherein the mapping includes a firstsub-mapping from the view to portions of heart anatomy within the view,and a second sub-mapping from the portions of heart anatomy within theview to the subset of measurements.
 3. The system according to claim 2,wherein the first sub-mapping includes sub-views.
 4. The systemaccording to claim 1, wherein the selected measurement is anon-structural measurement.
 5. The system according to claim 1, furtherincluding: a sequence tagging unit configured to determine the anatomyin the view from an analysis of the ultrasound imaging sequence.
 6. Thesystem according to claim 1, wherein the list of echocardiogrammeasurements is stored as a lookup table that comprises elementsrepresenting different measurements according to corresponding views. 7.The system according to claim 1, wherein the subset of measurements areordered according to usability statistics.
 8. The system according toclaim 1, wherein the measurement tool selects and applies at least onemeasurement of the subset of measurements to the view of the ultrasoundimaging sequence autonomously.
 9. The system according to claim 1,wherein the subset of the type of measurements does not include adiameter of an inferior vena cava of the heart of the subject, whereinthe image view does not include pixels that represent the inferior venacava of the heart of the subject.
 10. The system according to claim 1,wherein the mapping further maps each of the image views to anatomy inthe image view, and the processor is further configured to display theparticular image view, the determined subset of the plurality ofdifferent types of measurements, and the anatomy in the image view. 11.The system according to claim 1, wherein the mapping further maps eachof the image views to anatomy in the image view, and the processor isfurther configured to determine anatomy in the particular image view anddetermine the subset of the plurality of different types of measurementsbased on the anatomy in the image view.
 12. A method, comprising:determining which measurements from a list of possible echocardiogrammeasurements are applicable to anatomy in a view of an ultrasoundimaging sequence based on a mapping between the view and the possibleechocardiogram measurements, wherein the determined measurements are asubset of the possible echocardiogram measurements, and the measurementsof the list of possible echocardiogram measurements that are notapplicable to any of the anatomy in the view are not included in thesubset; displaying the determined subset of measurements in a userselectable list and the view of the ultrasound imaging sequence on auser interface displayed on a display device; and in response to aninput selecting one of the displayed subset of measurements, measuringan aspect of the heart in the view according to the one selecteddisplayed subset of measurement.
 13. The method according to claim 12,wherein the mapping includes a first sub-mapping from the view toportions of heart anatomy within the view, and a second sub-mapping fromthe portions of heart anatomy within the view to the subset ofmeasurements.
 14. The method according to claim 12 wherein thedisplaying comprises displaying only the determined subset ofmeasurements in the selectable list and not displaying a remainder ofthe list of measurements in the selectable list.
 15. The methodaccording to claim 14, wherein the displayed subset of measurements areordered according to usability statistics.
 16. The method according toclaim 12, further including: determining the view from an analysis ofthe ultrasound imaging sequence.
 17. The method according to claim 12,wherein the list of echocardiogram measurements is stored as a lookuptable that comprises elements representing different measurementsaccording to corresponding views.
 18. The method according to claim 12,further comprising: selecting and applying at least one measurement ofthe subset of measurements to the view of the ultrasound imagingsequence autonomously.
 19. An apparatus, comprising: a memory configuredto store a mapping that maps each image view of a plurality of differentimage views to one or more types of measurements of a plurality ofdifferent types of measurements, wherein the one or more types ofmeasurements for a particular image view of the plurality of differentimage views are applicable to be computed from the particular image viewand represent a subset of the plurality of different types ofmeasurements; a processor configured to: determine the subset of theplurality of different types of measurements for the particular imageview from the mapping; display the particular image view and thedetermined subset of the plurality of different types of measurementswith a display, wherein the plurality of different types of measurementsare displayed in a user selectable list; receive an input selecting oneof the displayed types of measurements in the list; and compute a valuefor the selected type measurement based on the anatomy in the imageview.
 20. The apparatus according to claim 19, wherein the image viewincludes pixels that represent at least a left ventricle of a heart of asubject and the type of measurement is left ventricular ejectionfraction.